Comparative Study of Efficacy and Safety of Intravenous Labetalol and Intravenous Hydralazine in managing Hypertensive Emergencies in Pregnancy

Abstract

ABSTRACT Objectives Evaluation of efficacy and safety of intravenous labetalol and intravenous hydralazine in managing hypertensive emergency in pregnancy. Study design An open, randomized comparison of intravenous labetatol vs intravenous hydralazine was conducted in 100 pregnant women presenting with hypertensive emergency during pregnancy. Materials and methods: Inclusion criteria Women with severe hypertension in pregnancy at 34 weeks of gestation or more, i.e., systolic BP ≥160 mm Hg or diastolic BP ≥ 110 mm Hg with or without proteinuria either in labor or not in labor. Results The antihypertensive efficacy of both the drugs was found to be comparable. The primary outcome in terms of BP control was achieved in both the groups. There were four treatment failures in labetalol group and none in hydralazine group. No significant difference was observed in maternal and fetal outcomes. Palpitation and tachycardia occurred significantly more often in patients treated with hydralazine. Bradycardia was significantly more frequent in labetalol group. The neonatal outcomes were similar per group. Conclusion The randomized clinical trial showed that labetalol and hydralazine fulfil the criteria required for an antihypertensive drug to treat severe hypertension in pregnancy. Hydralazine has its side effects like palpitation, headache, oliguria, dizziness, muscle cramps, and nasal congestion, which mimic symptoms of deteriorating pre-eclampsia. Labetalol has a better side effect profile, but specific concerns have been raised about the risk of neonatal bradycardia. How to cite this article Singh R, Singh S, Singh S, Agarwal M, Anand S, Yadav NK. Comparative Study of Efficacy and Safety of Intravenous Labetalol and Intravenous Hydralazine in managing Hypertensive Emergencies in Pregnancy. J South Asian Feder Obst Gynae 2016;8(3):185-188.